| NPI | 1639016207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLIN KROEGER Owner 218-310-1357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-05-01 |
| Last Update Date | 2026-05-01 |